BNF for Children (BNFC)

10th June 2025

BNF for Children

This update contains 7 significant changes, 3 dose changes and 2 new monographs.

Significant Changes:

• Hydroxychloroquine sulfate: updated pregnancy and breast-feeding advice.
• Malaria, prophylaxis: updated guidance.
• Neonatal infection, antibacterial therapy: updated guidance Sepsis: updated guidance on management.
• Parenteral anticoagulants: updated guidance for use of heparin flushes.
• Sepsis: updated guidance on management.
• Sympathomimetics: updated guidance for septic shock.
• Tuberculosis: updated guidance for multi-drug resistant tuberculosis.

Dose Changes:

• Rilpivirine [update to dosing for HIV-1 infection].
• Sodium hyaluronate with trehalose [update to dosing for dry eye conditions].
• Vocabria® (cabotegravir) [update to dosing for HIV-1 infection].

New Monographs:

• Apretude® [cabotegravir].
• Duvyzat® [givinostat].

13th May 2025

BNF for Children

This update contains 5 significant changes, 1 dose change, 2 new monographs, 3 new preparations, and 1 deleted preparation.

Significant Changes:

• Amphotericin B: review of indications and dose for liposomal preparations, as well as updates to directions for administration, breast-feeding, pregnancy, cautions, and monitoring advice.
• Asthma, chronic: updated guidance on management.
• Budesonide with formoterol (DuoResp Spiromax® 160 micrograms/4.5 micrograms): new indication and dose for mild asthma, reliever therapy.
• Budesonide with formoterol (Fobumix® 160/4.5 Easyhaler): new indication and dose for mild asthma, reliever therapy.
• Prolonged-release opioids: removal of indication for relief of post-operative pain [MHRA/CHM advice] (advice in all opioids; see example in oxycodone hydrochloride).

Dose Changes:

• Rosuvastatin [update to dose adjustments due to interactions].

New Monographs:

• Ospolot® [sultiame].
• Winlevi® [clascoterone].

New Preparations: Fobumix® 80/4.5 Easyhaler [budesonide with formoterol]; Fobumix® 160/4.5 Easyhaler [budesonide with formoterol]; Fobumix® 320/9 Easyhaler [budesonide with formoterol].

Deleted Preparations: Ambisome® [amphotericin B].

8th April 2025

BNF for Children

This update contains 7 significant changes, 2 dose changes, 2 new monographs, and 1 deleted monograph.

Significant Changes:

• Anaemia, iron deficiency: updated guidance for oral iron.
• Emtricitabine with tenofovir alafenamide: new indication and dose for pre-exposure prophylaxis of HIV-1.
• GLP-1 and dual GIP/GLP-1 receptor agonists: potential risk of pulmonary aspiration during general anaesthesia or deep sedation [MHRA/CHM advice] (advice in dulaglutide, liraglutide, semaglutide; see example in liraglutide).
• Immunisation schedule: updated guidance for immunisation against diphtheria, tetanus, pertussis and poliomyelitis in children aged 3 years and 4 months.
• Oral iron: indications and doses updated for iron-deficiency anaemia (advice in ferrous sulfate, ferrous fumarate, ferrous gluconate, sodium feredetate; see example in ferrous sulfate).
• Sodium valproate: new advice for male patients already taking sodium valproate [MHRA/CHM advice].
• Valproic acid: new advice for male patients already taking valproic acid [MHRA/CHM advice].

Dose Changes:

• Dupilumab [update to dosing].
• Evinacumab [update to dosing].

New Monographs:

• Agamree® [vamorolone].
• Joenja® [leniolisib].

Deleted Monographs: Ferrous sulfate with folic acid.

11th March 2025

BNF for Children

This update contains 1 significant change and 2 new preparations.

Significant Changes:

• Pneumococcal polysaccharide conjugate vaccine (adsorbed): name change of Apexxnar® to Prevenar 20®.

New Preparations: Hyftor® [sirolimus]; Verorab® [rabies vaccine].

11th February 2025

BNF for Children

This update contains 1 dose change, 2 new monographs, 1 new preparation and 1 deleted monographs.

Dose Changes:

• Ferric carboxymaltose [update to age range for iron-deficiency anaemia].

New Monographs:

• Loargys® [pegzilarginase].
• Xalkori® [crizotinib].

New Preparations: Prostap PD DCS® [leuprorelin acetate].

Deleted Monographs: Co-simalcite.

14th January 2025

BNF for Children

This update contains 13 significant changes, 4 dose changes, 2 new monographs, 2 new preparations and 2 deleted monographs.

Significant Changes:

Cefotaxime: removal of indication and dose for emergency treatment of suspected bacterial meningitis or meningococcal disease, before urgent transfer to hospital, in patients who cannot be given benzylpenicillin.

Ceftriaxone: update to indications and dosing for pre-hospital treatment of suspected bacterial meningitis and meningococcal disease.

Central nervous system infections, antibacterial therapy: updated guidance on management.

Chloramphenicol: updated monitoring advice.

Dexamethasone: update to dose advice for adjunctive treatment of suspected bacterial meningitis.

Fever: updated guidance on management.

GLP-1 receptor agonists: reminder of the potential side effects and to be aware of the potential for misuse [MHRA/CHM advice] (advice in dulaglutide, liraglutide and semaglutide; see example in liraglutide).

Medical emergencies in the community: update to antibacterials for suspected bacterial meningitis and meningococcal disease.

Medroxyprogesterone acetate: risk of meningioma and measures to minimise this risk [MHRA/CHM advice].

Neonatal infection, antibacterial therapy: updated guidance on management.

Respiratory system infections, antibacterial therapy: updated guidance on fluoroquinolones.

Urinary-tract infections: updated guidance on fluoroquinolones.

Urinary-tract infections: updated guidance on treatment of lower urinary-tract infections.

Dose Changes:

Cefotaxime [removal of intramuscular route for severe susceptible infections due to sensitive Gram-positive and Gram-negative bacteria, and meningitis].

Ceftriaxone [removal of intramuscular route for meningitis].

Ceftriaxone [update to indications and dosing for meningitis and meningococcal disease].

Fluconazole [update to indications and dosing].

New Monographs:

Piasky® [crovalimab].

Sogroya® [somapacitan].

New Preparations: Alutard SQ Bee® [bee venom extract]; Alutard SQ Wasp® [wasp venom extract].

Deleted Monographs: Crizanlizumab; Voxelotor.